Prevalence of Multiple Chronic Conditions Among US Adults

Estimates From the National Health Interview Survey, 2010

Brian W. Ward, PhD; Jeannine S. Schiller, MPH

Disclosures

Prev Chronic Dis. 2013;10 

In This Article

Abstract and Introduction

Abstract

Preventing and ameliorating chronic conditions has long been a priority in the United States; however, the increasing recognition that people often have multiple chronic conditions (MCC) has added a layer of complexity with which to contend. The objective of this study was to present the prevalence of MCC and the most common MCC dyads/triads by selected demographic characteristics. We used respondent-reported data from the 2010 National Health Interview Survey (NHIS) to study the US adult civilian noninstitutionalized population aged 18 years or older (n = 27,157). We categorized adults as having 0 to 1, 2 to 3, or 4 or more of the following chronic conditions: hypertension, coronary heart disease, stroke, diabetes, cancer, arthritis, hepatitis, weak or failing kidneys, chronic obstructive pulmonary disease, or current asthma. We then generated descriptive estimates and tested for significant differences. Twenty-six percent of adults have MCC; the prevalence of MCC has increased from 21.8% in 2001 to 26.0% in 2010. The prevalence of MCC significantly increased with age, was significantly higher among women than men and among non-Hispanic white and non-Hispanic black adults than Hispanic adults. The most common dyad identified was arthritis and hypertension, and the combination of arthritis, hypertension, and diabetes was the most common triad. The findings of this study contribute information to the field of MCC research. The NHIS can be used to identify population subgroups most likely to have MCC and potentially lead to clinical guidelines for people with more common MCC combinations.

Introduction

Chronic conditions are an increasing concern in the United States, where they affect nearly half of the adult population and their prevalence has increased in recent years.[1–3] These conditions result in numerous adverse health outcomes, increased health care needs, and subsequently higher medical costs.[4–6] In the past, strategies have focused on preventing and ameliorating a single disease at a time; however, the large percentage of people with 2 or more conditions, or multiple chronic conditions (MCC), has added a layer of complexity to developing prevention and intervention strategies.[7–10] As a result, the US Department of Health and Human Services (HHS) has developed a strategic framework to address MCC.[11] Strategies of the framework include the stimulation of epidemiologic research to determine the most common MCC dyads and triads and to explain more clearly the differences in MCC and the opportunities for prevention and treatment among various sociodemographic groups.[10,11]

Although numerous data sources are available to help meet these data-driven objectives, the National Health Interview Survey (NHIS) can be used to generate estimates of MCC that are representative of the noninstitutionalized, civilian adult population of the United States. The NHIS contains extensive sociodemographic and health data that can be studied with MCC. Furthermore, because it is conducted continuously, it can be used to monitor trends in MCC over time.

The main objective of this study was to use nationally representative data from the 2010 NHIS to examine the prevalence of MCC by select sociodemographic groups, and the prevalence of MCC dyads and triads among US adults. A secondary objective was to use earlier data from the NHIS to examine trends in MCC during 2001–2010.

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